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PLANNED PARENTHOOD CHALLENGES. 1997; (1-2):28-30.The percentage of people living in poverty in Nicaragua's cities has increased significantly in recent years and reflects an increase in the number of households headed by women. Among the nongovernmental organizations created to help meet the needs of Nicaragua's population is Profamilia, the International Planned Parenthood Federation affiliate founded in 1971. Profamilia offers high quality sexual and reproductive health services at regional clinics operating in 9 out of 16 political subdivisions and manages a nationwide network of over 1000 community-based contraceptive distribution posts. Knowledge of modern contraception is almost universal in Nicaragua, and a 1992-93 health survey revealed that almost half of women of reproductive age were using contraception. Profamilia uses the mass media and other means to advertise its services, which are preferred by many over the free government services. In the communities, trained volunteer promoters distribute contraceptives and provide counseling. Because adolescent pregnancy and fertility rates are high, Profamilia has developed services, including educational workshops, that target youth. These workshops offer information on responsible sex behavior and ways to reduce the risk of pregnancy or infection. In addition, Profamilia offers training courses for teachers and educational sessions for parents, pregnant adolescents, and adolescent parents.